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Morales JS, Alberquilla Del Río E, Valenzuela PL, Martínez-de-Quel Ó. Physical Activity and Cognitive Performance in Early Childhood: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Sports Med 2024:10.1007/s40279-024-02020-5. [PMID: 38598150 DOI: 10.1007/s40279-024-02020-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/11/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Growing evidence suggests that physical activity (PA) could improve cognitive performance in youths, but whether these effects occur from early childhood remains unclear. OBJECTIVE To summarize evidence on the effects of PA interventions on cognitive performance in early childhood. METHODS We performed a systematic search in PubMed, Scopus, Web of Science and PsycINFO (from inception to 6 September 2023) for randomized controlled trials assessing the effects of PA interventions (≥ 3 weeks) on cognitive-related outcomes in early childhood (3-6 years). We conducted a random-effects meta-analysis when five or more studies assessed a given outcome. The potential moderating role of participant (e.g., age) and intervention characteristics (e.g., duration, volume, intensity, cognitive engagement) was also assessed. RESULTS We found a total of 24 studies (N = 3483 children) that were deemed to be of overall fair methodological quality. PA interventions were supervised and lasted between 3 and 24 weeks. The most common session duration was 30 min, with a frequency of two sessions per week. Pooled analyses revealed that PA interventions have positive effects on all analysed outcomes, including attention (standardized mean difference (SMD) = 0.49, 95% confidence interval (CI) 0.18-0.79, p = 0.002), inhibition (SMD = 0.45, 95% CI 0.06-0.84, p = 0.022), working memory (SMD = 0.50, 95% CI 0.18-0.82, p = 0.002), cognitive flexibility (SMD = 0.39, 0.15-0.62, p = 0.002) and vocabulary (SMD = 1.18, 0.19-2.16, p = 0.019). Sensitivity analyses confirmed the benefits in all cases except for inhibition (p = 0.062). No consistent differences were found relating to any moderator variable. CONCLUSIONS Although further research is warranted, our findings suggest that PA interventions may improve cognitive performance in early childhood, particularly in the domains of attention, inhibition, working memory, cognitive flexibility and vocabulary. These findings might support the implementation of PA interventions from early childhood. PROSPERO REGISTRATION CRD42021249319.
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Affiliation(s)
- Javier S Morales
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain
| | | | - Pedro L Valenzuela
- Physical Activity and Health Research Group ('PaHerg'), Research Instituto de Investigación Hospital 12 de Octubre ('imas12'), Centro de Actividades Ambulatorias, 7ª Planta, Bloque D. Av. de Córdoba s/n, 28041, Madrid, Spain.
- Systems Biology Department, University of Alcalá, Madrid, Spain.
| | - Óscar Martínez-de-Quel
- Faculty of Education, Complutense University of Madrid, Madrid, Spain
- Faculty of Physical Activity and Sport Sciences (INEF), Technical University of Madrid, Madrid, Spain
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Dowda M, Saunders RP, Dishman RK, Pate RR. Association of physical activity, sedentary behavior, diet quality with adiposity: a longitudinal analysis in children categorized by baseline weight status. Int J Obes (Lond) 2024; 48:240-246. [PMID: 37932409 DOI: 10.1038/s41366-023-01405-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND/OBJECTIVES Childhood obesity rates have increased in recent years. The effectiveness of future public health interventions to reduce childhood obesity will be enhanced by a better understanding of behavioral factors that influence adiposity in children as they transition from childhood to adolescence. The purpose of this study was to examine whether initial weight status modifies the longitudinal associations of physical activity, sedentary behavior, and diet quality with changes in adiposity over time. SUBJECTS/METHODS A total of 658 children (45% boys) were stratified into 3 groups based on 5th grade BMI percentiles ( < 85th, 85-95th, > 95th) and followed from 5th grade to 6th and/or 7th grade. Study variables, including fat-mass-index (FMI), moderate-to-vigorous physical activity (MVPA), diet quality, and sedentary behavior, were measured at 5th, 6th, and/or 7th grades. Separate growth curve models were conducted within each weight status group to examine the associations between MVPA, sedentary behavior, diet quality and adiposity, operationalized as FMI. All models controlled for sex, maturity offset, race, and parent education. RESULTS Of the 658 children, 53% were classified with normal weight at baseline, 18% with overweight, and 29% with obesity. Associations between MVPA, sedentary behavior, diet quality and FMI varied within each weight status group. MVPA was negatively associated with adiposity (FMI) for all weight status groups. Diet quality and sedentary behavior were associated with adiposity only in children with obesity at baseline; neither diet quality nor sedentary behavior was associated with FMI for those with overweight. CONCLUSIONS MVPA was negatively associated with adiposity (FMI) in all weight status groups, suggesting that MVPA may protect against higher adiposity. Sedentary behavior and diet quality were associated with adiposity only in children with obesity at baseline; neither sedentary behavior nor diet quality was associated with FMI for children with overweight.
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Affiliation(s)
- Marsha Dowda
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC, 29208, USA.
| | - Ruth P Saunders
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC, 29208, USA
| | - Rod K Dishman
- Department of Kinesiology, The University of Georgia, Ramsey Student Center, 330 River Road, Athens, GA, 30602-6554, USA
| | - Russell R Pate
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Suite 212, Columbia, SC, 29208, USA
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García-Hermoso A, López-Gil JF, Izquierdo M, Ramírez-Vélez R, Ezzatvar Y. Exercise and Insulin Resistance Markers in Children and Adolescents With Excess Weight: A Systematic Review and Network Meta-Analysis. JAMA Pediatr 2023; 177:1276-1284. [PMID: 37812414 PMCID: PMC10562991 DOI: 10.1001/jamapediatrics.2023.4038] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 08/10/2023] [Indexed: 10/10/2023]
Abstract
Importance Although benefits have been reported for most exercise modalities, the most effective exercise approaches for reducing insulin resistance in children and adolescents with excess weight and the optimal exercise dose remain unknown. Objective To compare exercise training modalities and their association with changes in insulin resistance markers among children and adolescents with excess weight and to establish the optimal exercise dose. Data Sources For this systematic review and network meta-analysis, 6 electronic databases (PubMed, EMBASE, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and CINAHL) were searched for studies from inception to April 1, 2023. Study Selection Randomized clinical trials (ie, randomized controlled trials and randomized trials without a control group) were included if they reported outcomes associated with aerobic training, resistance training, high-intensity interval training (HIIT), or a combination of these interventions. Data Extraction and Synthesis Data extraction for this systematic review was conducted following a network meta-analysis extension of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guideline. Effect sizes were calculated as the mean difference (MD) with 95% CI using random-effects inverse-variance models with the Hartung-Knapp-Sidik-Jonkman method. The hierarchy of competing interventions was defined using the surface under the cumulative ranking curve. The Cochrane Risk-of-Bias tool, version 2 (RoB2), was used to independently assess the risk of bias of the included studies. The certainty of evidence in consistent networks was assessed using the Grading of Recommendation, Assessment, Development and Evaluation approach. The study protocol was prospectively registered with PROSPERO. Data analyses were conducted between May and June 2023. Main Outcomes and Measures The primary outcomes were fasting glucose, insulin, and homeostatic model assessment for insulin resistance (HOMA-IR). Results This analysis included 55 studies with a total of 3051 children and adolescents (mean [SD] age, 13.5 [2.3] years; 1537 girls [50.4%] and 1514 boys [49.6%]). Exercise was associated with reductions in fasting insulin (MD, -4.38 μU/mL [95% CI, -5.94 to -2.82 μU/mL]) and HOMA-IR (MD, -0.87 [95% CI, -1.20 to -0.53]). A nonlinear association in both markers was observed, with a required minimal exercise dosage of approximately 900 to 1200 metabolic equivalent of task minutes per week, especially in children and adolescents with insulin resistance at baseline. Combination HIIT and resistance training and concurrent training were the most effective approaches for reducing insulin resistance markers. On average, the certainty of evidence varied from low to moderate. Conclusions and Relevance These findings underscore the role of exercise interventions in enhancing insulin resistance markers among children and adolescents with overweight and obesity. It is advisable to include resistance exercises alongside aerobic and HIIT programs for a minimum of two to three 60-minute sessions per week.
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Affiliation(s)
- Antonio García-Hermoso
- Navarrabiomed, Instituto de Investigación Sanitaria de Navarra, Hospital Universitario de Navarra, Universidad Pública de Navarra, Pamplona, Spain
| | - José Francisco López-Gil
- Navarrabiomed, Instituto de Investigación Sanitaria de Navarra, Hospital Universitario de Navarra, Universidad Pública de Navarra, Pamplona, Spain
- One Health Research Group, Universidad de Las Américas, Quito, Ecuador
| | - Mikel Izquierdo
- Navarrabiomed, Instituto de Investigación Sanitaria de Navarra, Hospital Universitario de Navarra, Universidad Pública de Navarra, Pamplona, Spain
- Centro de Investigación Biomédica en Red Sobre Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Instituto de Investigación Sanitaria de Navarra, Hospital Universitario de Navarra, Universidad Pública de Navarra, Pamplona, Spain
- Centro de Investigación Biomédica en Red Sobre Fragilidad y Envejecimiento Saludable, Instituto de Salud Carlos III, Madrid, Spain
| | - Yasmin Ezzatvar
- Department of Nursing, Universitat de València, Valencia, Spain
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D'Alleva M, Lazzer S, Tringali G, De Micheli R, Bondesan A, Abbruzzese L, Sartorio A. Effects of combined training or moderate intensity continuous training during a 3-week multidisciplinary body weight reduction program on cardiorespiratory fitness, body composition, and substrate oxidation rate in adolescents with obesity. Sci Rep 2023; 13:17609. [PMID: 37848570 PMCID: PMC10582026 DOI: 10.1038/s41598-023-44953-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/13/2023] [Indexed: 10/19/2023] Open
Abstract
This study aimed to investigate the effects of combined training (COMB, a combination of moderate-intensity continuous training-MICT and high-intensity interval training-HIIT) vs. continuous MICT administered during a 3-week in-hospital body weight reduction program (BWRP) on body composition, physical capacities, and substrate oxidation in adolescents with obesity. The 3-week in-hospital BWRP entailed moderate energy restriction, nutritional education, psychological counseling, and two different protocols of physical exercise. Twenty-one male adolescents with obesity (mean age: 16.1 ± 1.5 years; mean body mass index [BMI] 37.8 ± 4.5 kg m-2) participated in this randomized control trial study (n:10 for COMB, n:11 MICT), attending ~ 30 training sessions. The COMB group performed 3 repetitions of 2 min at 95% of peak oxygen uptake (V'O2 peak) (e.g., HIIT ≤ 20%), followed by 30 min at 60% of V'O2 peak (e.g., MICT ≥ 80%). Body composition, V'O2 peak, basal metabolic rate (BMR), energy expenditure, and substrate oxidation rate were measured during the first week (W0) and at the end of three weeks of training (W3). The two training programs were equivalent in caloric expenditure. At W3, body mass (BM) and fat mass (FM) decreased significantly in both groups, although the decrease in BM was significantly greater in the MICT group than in the COMB group (BM: - 5.0 ± 1.2 vs. - 8.4 ± 1.5, P < 0.05; FM: - 4.3 ± 3.0 vs. - 4.2 ± 1.9 kg, P < 0.05). V'O2 peak increased only in the COMB by a mean of 0.28 ± 0.22 L min-1 (P < 0.05). The maximal fat oxidation rate (MFO) increased only in the COMB group by 0.04 ± 0.03 g min-1 (P < 0.05). COMB training represents a viable alternative to MICT for improving anthropometric characteristics, physical capacities, and MFO in adolescents with obesity during a 3-week in-hospital BWRP.
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Affiliation(s)
- Mattia D'Alleva
- Department of Medicine, University of Udine, P.le Kolbe 4, 33100, Udine, Italy.
- School of Sport Science, University of Udine, Udine, Italy.
| | - Stefano Lazzer
- Department of Medicine, University of Udine, P.le Kolbe 4, 33100, Udine, Italy
- School of Sport Science, University of Udine, Udine, Italy
| | - Gabriella Tringali
- Experimental Laboratory for Auxo-endocrinological Research, Istituto Auxologico Italiano, IRCCS, Piancavallo-Verbania, Italy
| | - Roberta De Micheli
- Experimental Laboratory for Auxo-endocrinological Research, Istituto Auxologico Italiano, IRCCS, Piancavallo-Verbania, Italy
| | - Adele Bondesan
- Experimental Laboratory for Auxo-endocrinological Research, Istituto Auxologico Italiano, IRCCS, Piancavallo-Verbania, Italy
| | - Laura Abbruzzese
- Experimental Laboratory for Auxo-endocrinological Research, Istituto Auxologico Italiano, IRCCS, Piancavallo-Verbania, Italy
| | - Alessandro Sartorio
- Experimental Laboratory for Auxo-endocrinological Research, Istituto Auxologico Italiano, IRCCS, Piancavallo-Verbania, Italy
- Experimental Laboratory for Auxo-endocrinological Research, Istituto Auxologico Italiano, IRCCS, Milan, Italy
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Kazeminasab F, Sharafifard F, Miraghajani M, Behzadnejad N, Rosenkranz SK. The effects of exercise training on insulin resistance in children and adolescents with overweight or obesity: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1178376. [PMID: 37635963 PMCID: PMC10450243 DOI: 10.3389/fendo.2023.1178376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/03/2023] [Indexed: 08/29/2023] Open
Abstract
Aim The aim of present meta-analysis was to determine the effects of exercise training (Exe) on insulin resistance (IR) and body weight in children and adolescents with overweight or obesity. Methods PubMed, Web of Science, and Scopus were searched for original articles, published through October 2022 that included exercise versus control interventions on fasting glucose, insulin, HOMA-IR, and body weight outcomes in children and adolescents with overweight or obesity. Standardized mean differences (SMD) for fasting insulin, and weighted mean differences (WMD) for fasting glucose, HOMA-IR, body weight (BW), and 95% confidence intervals were determined using random effects models. Results Thirty-five studies comprising 1,550 children and adolescents with overweight and obesity were included in the present meta-analysis. Exercise training reduced fasting glucose (WMD=-2.52 mg/dL, p=0.001), fasting insulin (SMD=-0.77, p=0.001), HOMA-IR (WMD=-0.82, p=0.001), and BW (WMD=-1.51 kg, p=0.001), as compared to a control. Subgroup analyses showed that biological sex, intervention duration, type of exercise training, BMI percentile, and health status (with or without diagnosed condition), were sources of heterogeneity. Conclusion Exercise training is effective for lowering fasting glucose, fasting insulin, HOMA-IR, and BW in children and adolescents with overweight or obesity and could provide an important strategy for controlling IR and related factors. With clear evidence for the effectiveness of exercise interventions in this vulnerable population, it is important to determine effective approaches for increasing exercise training in children and adolescents with overweight or obesity.
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Affiliation(s)
- Fatemeh Kazeminasab
- Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran
| | - Fatemeh Sharafifard
- Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran
| | - Maryam Miraghajani
- Department of Cancer Research Center, Shahid Beheshti of Medical Sciences, Tehran, Iran
| | - Nasim Behzadnejad
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Isfahan, Isfahan, Iran
| | - Sara K. Rosenkranz
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV, United States
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Affiliation(s)
- Tamara S Hannon
- From the Department of Pediatrics, Division of Pediatric Endocrinology and Diabetology, Indiana University School of Medicine, Indianapolis (T.S.H.); and the Center for Pediatric Research in Obesity and Metabolism and the Division of Pediatric Endocrinology, Metabolism, and Diabetes Mellitus, UPMC Children's Hospital of Pittsburgh, Pittsburgh (S.A.A.)
| | - Silva A Arslanian
- From the Department of Pediatrics, Division of Pediatric Endocrinology and Diabetology, Indiana University School of Medicine, Indianapolis (T.S.H.); and the Center for Pediatric Research in Obesity and Metabolism and the Division of Pediatric Endocrinology, Metabolism, and Diabetes Mellitus, UPMC Children's Hospital of Pittsburgh, Pittsburgh (S.A.A.)
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Migueles JH, Cadenas-Sanchez C, Lubans DR, Henriksson P, Torres-Lopez LV, Rodriguez-Ayllon M, Plaza-Florido A, Gil-Cosano JJ, Henriksson H, Escolano-Margarit MV, Gómez-Vida J, Maldonado J, Löf M, Ruiz JR, Labayen I, Ortega FB. Effects of an Exercise Program on Cardiometabolic and Mental Health in Children With Overweight or Obesity: A Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2324839. [PMID: 37498603 PMCID: PMC10375312 DOI: 10.1001/jamanetworkopen.2023.24839] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 06/06/2023] [Indexed: 07/28/2023] Open
Abstract
Importance Childhood obesity is a risk factor associated with type 2 diabetes, cardiovascular disease, and mental disorders later in life. Investigation of the parallel effects of a defined exercise program on cardiometabolic and mental health in children with overweight or obesity may provide new insights on the potential benefits of exercise on overall health. Objective To investigate the effects of a 20-week exercise program on cardiometabolic and mental health in children with overweight or obesity. Design, Setting, and Participants This secondary analysis of a parallel-group randomized clinical trial was conducted in Granada, Spain, from November 1, 2014, to June 30, 2016. Data analyses were performed between February 1, 2020, and July 14, 2022. Children with overweight or obesity aged 8 to 11 years were eligible, and the study was performed in an out-of-school context. Intervention The exercise program included 3 to 5 sessions/wk (90 min/session) of aerobic plus resistance training for 20 weeks. The wait-list control group continued with their usual routines. Main Outcomes and Measures Cardiometabolic outcomes as specified in the trial protocol included body composition (fat mass, fat-free mass, and visceral adipose tissue), physical fitness (cardiorespiratory, speed-agility, and muscular), and traditional risk factors (waist circumference, blood lipid levels, glucose levels, insulin levels, and blood pressure). Cardiometabolic risk score (z score) was calculated based on age and sex reference values for levels of triglycerides, inverted high-density lipoprotein cholesterol, and glucose, the mean of systolic and diastolic blood pressure, and waist circumference. An additional cardiometabolic risk score also included cardiorespiratory fitness. Mental health outcomes included an array of psychological well-being and ill-being indicators. Results The 92 participants included in the per-protocol analyses (36 girls [39%] and 56 boys [61%]) had a mean (SD) age of 10.0 (1.1) years. The exercise program reduced the cardiometabolic risk score by approximately 0.38 (95% CI, -0.74 to -0.02) SDs; decreased low-density lipoprotein cholesterol level by -7.00 (95% CI, -14.27 to 0.37) mg/dL (to convert to mmol/L, multiply by 0.0259), body mass index (calculated as weight in kilograms divided by height in meters squared) by -0.59 (95% CI, -1.06 to -0.12), fat mass index by -0.67 (95% CI, -1.01 to -0.33), and visceral adipose tissue by -31.44 (95% CI, -58.99 to -3.90) g; and improved cardiorespiratory fitness by 2.75 (95% CI, 0.22-5.28) laps in the exercise group compared with the control group. No effects were observed on mental health outcomes. Conclusions and Relevance In this secondary analysis of a randomized clinical trial, an aerobic plus resistance exercise program improved cardiometabolic health in children with overweight or obesity but had no effect on mental health. Trial Registration ClinicalTrials.gov Identifier: NCT02295072.
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Affiliation(s)
- Jairo H. Migueles
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Cristina Cadenas-Sanchez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
- CIBER (Centro de Investigación Biomédica en Red) de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Granada, Spain
- Department of Cardiology, Stanford University, Stanford, California
- Palo Alto Health Care System, Veterans Affairs Medical Center, Palo Alto, California
| | - David R. Lubans
- Centre for Active Living and Learning, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Lucia V. Torres-Lopez
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
| | - María Rodriguez-Ayllon
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
- Department of Epidemiology, Erasmus University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Abel Plaza-Florido
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
- Pediatric Exercise and Genomics Research Center, Department of Pediatrics, School of Medicine, University of California at Irvine
| | - Jose J. Gil-Cosano
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
- Department of Communication and Education, Universidad Loyola Andalucía, Dos Hermanas, Sevilla, Spain
| | - Hanna Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | | | - José Gómez-Vida
- Department of Pediatrics. San Cecilio University Hospital, Granada, Spain
| | - José Maldonado
- Department of Pediatrics, School of Medicine, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
| | - Jonatan R. Ruiz
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
- CIBER (Centro de Investigación Biomédica en Red) de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada, Spain
| | - Idoia Labayen
- CIBER (Centro de Investigación Biomédica en Red) de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Granada, Spain
- Institute for Sustainability & Food Chain Innovation, Navarra Institute for Health Research, Department of Health Sciences, Public University of Navarra, Pamplona, Spain
| | - Francisco B. Ortega
- Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute, University of Granada, Granada, Spain
- Department of Biosciences and Nutrition, Karolinska Institutet, Stockholm, Sweden
- CIBER (Centro de Investigación Biomédica en Red) de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Granada, Spain
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Maffeis C, Olivieri F, Valerio G, Verduci E, Licenziati MR, Calcaterra V, Pelizzo G, Salerno M, Staiano A, Bernasconi S, Buganza R, Crinò A, Corciulo N, Corica D, Destro F, Di Bonito P, Di Pietro M, Di Sessa A, deSanctis L, Faienza MF, Filannino G, Fintini D, Fornari E, Franceschi R, Franco F, Franzese A, Giusti LF, Grugni G, Iafusco D, Iughetti L, Lera R, Limauro R, Maguolo A, Mancioppi V, Manco M, Del Giudice EM, Morandi A, Moro B, Mozzillo E, Rabbone I, Peverelli P, Predieri B, Purromuto S, Stagi S, Street ME, Tanas R, Tornese G, Umano GR, Wasniewska M. The treatment of obesity in children and adolescents: consensus position statement of the Italian society of pediatric endocrinology and diabetology, Italian Society of Pediatrics and Italian Society of Pediatric Surgery. Ital J Pediatr 2023; 49:69. [PMID: 37291604 DOI: 10.1186/s13052-023-01458-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 04/18/2023] [Indexed: 06/10/2023] Open
Abstract
This Position Statement updates the different components of the therapy of obesity (lifestyle intervention, drugs, and surgery) in children and adolescents, previously reported in the consensus position statement on pediatric obesity of the Italian Society of Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics. Lifestyle intervention is the first step of treatment. In children older than 12 years, pharmacotherapy is the second step, and bariatric surgery is the third one, in selected cases. Novelties are available in the field of the medical treatment of obesity. In particular, new drugs demonstrated their efficacy and safety and have been approved in adolescents. Moreover, several randomized control trials with other drugs are in process and it is likely that some of them will become available in the future. The increase of the portfolio of treatment options for obesity in children and adolescents is promising for a more effective treatment of this disorder.
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Affiliation(s)
- Claudio Maffeis
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy
| | - Francesca Olivieri
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy.
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, Parthenope University of Naples, Naples, Italy
| | - Elvira Verduci
- Deparment of Pediatrics, Department of Health Science, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy
| | - Maria Rosaria Licenziati
- Department of Neurosciences, Neuro-Endocrine Diseases and Obesity Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Valeria Calcaterra
- Department of Pediatrics, Vittore Buzzi Children's Hospital, Milan, Italy
- Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Gloria Pelizzo
- Department of Pediatric Surgery, Vittore Buzzi Children's Hospital, Milan, Italy
| | - Mariacarolina Salerno
- Department of Traslational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Annamaria Staiano
- Department of Traslational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | | | - Raffaele Buganza
- Pediatric Endocrinology Unit, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy
| | - Antonino Crinò
- Autoimmune Endocrine Diseases Unit, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | | | - Domenico Corica
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| | - Francesca Destro
- Department of Pediatric Surgery, Vittore Buzzi Children's Hospital, Milan, Italy
| | - Procolo Di Bonito
- Department of Internal Medicine, S. Maria Delle Grazie Hospital, Naples, Pozzuoli, Italy
| | - Mario Di Pietro
- Pediatric and Neonatal Unit, Hospital of Teramo and Atri, Teramo, Italy
| | - Anna Di Sessa
- Department of Woman, Child and General and Specialized Surgery, University of Campania L. Vanvitelli, Naples, Italy
| | - Luisa deSanctis
- Department of Sciences of Public Health and Pediatrics, University of Turin, Turin, Italy
| | - Maria Felicia Faienza
- Department of Precision and Regenerative Medicine and Ionan Area, University of Bari, Bari, Italy
| | | | - Danilo Fintini
- Refernce Center for Prader Willi Syndrome, Endocrinology and Diabetology Unit, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
| | - Elena Fornari
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy
| | | | - Francesca Franco
- Pediatric Department, Azienda Sanitaria Universitaria del Friuli Centrale, Hospital of Udine, Udine, Italy
| | - Adriana Franzese
- Department of Traslational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Lia Franca Giusti
- Italian Society for Pediatric Endocrinology and Diabetology (SIEDP), Lucca, Italy
| | - Graziano Grugni
- Division of Auxology, Istituto Auxologico Italiano, IRCCS, Verbania, Italy
| | - Dario Iafusco
- Department of Woman, Child and General and Specialized Surgery, University of Campania L. Vanvitelli, Naples, Italy
| | - Lorenzo Iughetti
- Department of Medical and Surgical Sciences of Mother, Children and Adults, Pediatric Unit, University of Modena and Reggio Emilia, Modena, Italy
| | - Riccardo Lera
- Italian Society for Pediatric Endocrinology and Diabetology (SIEDP), Alessandria, Italy
| | | | - Alice Maguolo
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy
| | - Valentina Mancioppi
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy
| | - Melania Manco
- Research Area for Multifactorial Diseases, Children's Hospital Bambino Gesù, Rome, Italy
| | | | - Anita Morandi
- Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy
| | - Beatrice Moro
- UOSD Diabetology, Complesso Ai Colli, AULSS 6 Euganea, Padua, Italy
| | - Enza Mozzillo
- Department of Traslational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Ivana Rabbone
- Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy
| | - Paola Peverelli
- Department of Pediatrics and Gynecology, Hospital of Belluno, Belluno, Italy
| | - Barbara Predieri
- Department of Medical and Surgical Sciences of Mother, Children and Adults, Pediatric Unit, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Stefano Stagi
- Department of Health Sciences, University of Florence, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Maria Elisabeth Street
- Department of Medicine and Surgery, Unit of Paediatrics, University of Parma, University Hospital of Parma, Parma, Italy
| | - Rita Tanas
- Italian Society for Pediatric Endocrinology and Diabetology (SIEDP), Ferrara, Italy
| | - Gianluca Tornese
- Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy
| | - Giuseppina Rosaria Umano
- Department of Woman, Child and General and Specialized Surgery, University of Campania L. Vanvitelli, Naples, Italy
| | - Malgorzata Wasniewska
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
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Soares R, Brasil I, Monteiro W, Farinatti P. Effects of physical activity on body mass and composition of school-age children and adolescents with overweight or obesity: Systematic review focusing on intervention characteristics. J Bodyw Mov Ther 2023; 33:154-163. [PMID: 36775513 DOI: 10.1016/j.jbmt.2022.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 04/18/2022] [Accepted: 09/17/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The characteristics of physical activity (PA) interventions to improve body mass and composition in pediatric populations are unclear. This systematic review summarized the effects of PA on those outcomes in school-age children and adolescents with overweight or obesity, focusing on training components (frequency, intensity, duration, and type - FITT). METHODS Databases were searched for controlled trials applying exclusive PA and including children (5-12 y) or adolescents (13-17 y) with overweight/obesity. RESULTS Twenty-seven trials yielding 34 interventions were included. PA was recreational (children: k = 9, n = 478), systematized (children: k = 18, n = 565); or combined (children: k = 7, n = 205). Successful interventions were performed for 6- to 35 weeks (mostly 12-14 weeks), 2- to 5 d/wk (mostly 3 d/wk), during 8- to 60 min (mainly 60 min) with moderate to high intensity (60-90% maximal heart rate or 40-70% heart rate reserve). Half of the interventions applying recreational (4 out of 8), 59% of systematized (10 out of 17), and 57% of combined (4 out of 7) interventions reported improvements in body mass or composition, especially body fat. Benefits were more often reported for body composition (18 out of 34 interventions) than body mass (8 out of 34 interventions), irrespective of the age group. CONCLUSION Recreational and systematized PA may improve body mass, and particularly body composition in school-age children and adolescents with overweight or obesity. Successful programs were performed for at least six weeks and applied a PA amount consistent with the minimum recommended for pediatric populations (≥60 min of moderate-to-vigorous PA at least 3 d/wk).
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Affiliation(s)
- Raphael Soares
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, Rio de Janeiro, RJ, Brazil.
| | - Iedda Brasil
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, Rio de Janeiro, RJ, Brazil.
| | - Walace Monteiro
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, Rio de Janeiro, RJ, Brazil.
| | - Paulo Farinatti
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, Rio de Janeiro, RJ, Brazil.
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10
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Peng S, Fang Y, Othman AT, Liang J. Meta-analysis and systematic review of physical activity on neurodevelopment disorders, depression, and obesity among children and adolescents. Front Psychol 2022; 13:940977. [PMID: 36533019 PMCID: PMC9747947 DOI: 10.3389/fpsyg.2022.940977] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 11/02/2022] [Indexed: 08/22/2023] Open
Abstract
Background No consensus on whether physical activity (PA) is related to physical and mental health among pediatric population remains has been reached to date. To further explore their association, our study assessed the effect of PA on physical and mental health of children and adolescents through a systematic review and meta-analysis of randomized controlled studies (RCTs). Methods Several databases(Web of science, PubMed, Embase, Cochrane Central register of controlled trials, CINAHL) were searched from inception to 1st, December 2020 without language restrictions. Results 38,236 records were identified primitively and 31 included studies with 1,255 participants eventually met our inclusion criteria, all of which exhibited a relatively low-moderate risk of bias of overall quality. In regard to mental health, the administration of PA, compared with the control group, led to moderate improvements in Autism Spectrum Disorder(ASD)[Standard mean difference (SMD) = -0.50, Confidence interval(CI): -0.87, -0.14)] and depression(SMD = -0.68, CI: -0.98, -0.38) among children and adolescents. Similarly, significant result was observed in obesity (SMD = -0.58, CI: -0.80, -0.36). No significant differences were observed in Attention deficit hyperactivity disorder (ADHD) (SMD = -0.29, CI: -0.59, 0.01). Conclusion Altogether, PA may have a beneficial effect on children and adolescents with ASD, depression and obesity; nevertheless, there is insufficient evidence to confirm its efficacy in ADHD. More large-scale population based randomized controlled trials are needed to explore more reliable evidence between them.
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Affiliation(s)
- Sanying Peng
- Department of Physical Education, Hohai University, Nanjing, China
- School of Educational Studies, Universiti Sains Malaysia, Penang, Malaysia
| | - Yuan Fang
- College of International Languages and Cultures of Hohai University, Nanjing, China
| | | | - Jinghong Liang
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China
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11
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Xin C, Ye M, Zhang Q, He H. Effect of Exercise on Vascular Function and Blood Lipids in Postmenopausal Women: A Systematic Review and Network Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191912074. [PMID: 36231376 PMCID: PMC9564891 DOI: 10.3390/ijerph191912074] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 06/01/2023]
Abstract
UNLABELLED This study aimed to compare and rank the effectiveness of aerobic exercise (AE), resistance training (RT), combined training (CT), and water exercise (WE) on vascular function and blood lipids in postmenopausal women using a network meta-analysis (NMA). METHODS We searched the PubMed, Cochrane, Embase, Web of Science, and EBSCO (SPORTDiscus) databases to identify randomized controlled trials investigating the effects of exercise on vascular function and blood lipids in postmenopausal women. The retrieval period was from inception to March 2022. Two reviewers independently screened the retrieved articles, extracted pertinent data, and assessed the risk of bias of the included studies. RESULTS A total of 38 studies involving 1407 patients were included in this study. The results of the NMA indicated that WE had the greatest effect on systolic blood pressure (SBP) (surface under the cumulative ranking [SUCRA] = 84.9) and total cholesterol (TC) (SUCRA = 93.1); CT had the greatest effect on triglycerides (TG) (SUCRA = 96.2), high-density lipoprotein cholesterol (HDL-C) (SUCRA = 94.8), and diastolic blood pressure (DBP) (SUCRA = 91.1); RT had the greatest effect on low-density lipoprotein cholesterol (LDL-C) (SUCRA = 79.4). CONCLUSION The results suggest that exercise can effectively improve the PWV, SBP, and DBP and the levels of TC, TG, and LDL-C in postmenopausal women. WE had the best effect on improving TC and SBP. CT had the best effect on improving TG, HDL-C, and DBP. To improve LDL-C, RT can achieve a good effect. Considering the limitations of NMA, more RCTS need to be performed in the future to provide more direct evidence of the effectiveness of various exercise interventions on vascular health in postmenopausal women.
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Affiliation(s)
- Chenxi Xin
- Department of Chinese Academy of Sport and Health, Beijing Sport University, Beijing 100084, China
| | - Mingyi Ye
- Department of Chinese Academy of Sport and Health, Beijing Sport University, Beijing 100084, China
| | - Qianqian Zhang
- Department of Physical Education, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Hui He
- Department of Chinese Academy of Sport and Health, Beijing Sport University, Beijing 100084, China
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Kelley GA, Kelley KS, Pate RR. Exercise and Cardiovascular Disease Risk Factors in Children and Adolescents With Obesity: A Systematic Review With Meta-Analysis of Randomized Controlled Trials. Am J Lifestyle Med 2022; 16:485-510. [PMID: 35860364 PMCID: PMC9290181 DOI: 10.1177/1559827620988839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to examine the effects of exercise on cardiovascular disease (CVD) risk factors in children and adolescents with obesity. Randomized controlled trials (RCTs) of exercise ≥4 weeks in children and adolescents with obesity were included if one or more CVD risk factors were included as an outcome. Studies were retrieved by searching 7 electronic databases, cross-referencing, and expert review. Data were pooled using the inverse-variance heterogeneity (IVhet) model and strength of evidence was assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument. Thirty-nine studies representing 1548 participants (847 exercise, 701 control) met the inclusion criteria. Aerobic exercise improved 10 of 12 (83.3%) outcomes (P < .05 for all) while combined aerobic and strength training improved 5 of 8 (62.5%) outcomes (P < .05 for all). The strength of evidence ranged from "very low" to "moderate." It was concluded that aerobic exercise, as well as combined aerobic and strength training, is associated with improvements in multiple CVD risk factors among children and adolescents with obesity. However, the generally low strength of evidence suggests a need for future well-designed and conducted RCTs on the effects of exercise, especially strength training, in children and adolescents with obesity.
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Affiliation(s)
- George A. Kelley
- School of Public Health, Department of Biostatistics, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, West Virginia
| | - Kristi S. Kelley
- School of Public Health, Department of Biostatistics, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, West Virginia
| | - Russell R. Pate
- Children’s Physical Activity Research Group, Department of Exercise Science, University of South Carolina, Columbia, South Carolina
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13
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Saullo C, Cruz LLD, Damasceno DC, Volpato GT, Sinzato YK, Karki B, Gallego FQ, Vesentini G. Effects of a maternal high-fat diet on adipose tissue in murine offspring: A systematic review and meta-analysis. Biochimie 2022; 201:18-32. [PMID: 35779649 DOI: 10.1016/j.biochi.2022.06.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 05/10/2022] [Accepted: 06/21/2022] [Indexed: 12/09/2022]
Abstract
The aim of this systematic review and meta-analysis was to analyze the influence of a maternal and/or offspring high-fat diet (HFD) on the morphology of the offspring adipocytes and amount of food and energy consumption. The search was conducted through Pubmed, EMBASE, and Web of Science databases up to October 31st, 2021. The outcomes were extracted and pooled as a standardized mean difference with random effect models. 5,004 articles were found in the databases. Of these, only 31 were selected for this systematic review and 21 were included in the meta-analysis. A large discrepancy in the percentage of fat composing the HFD (from 14% to 62% fat content) was observed. Considering the increase of adipose tissue by hyperplasia (cell number increase) and hypertrophy (cell size increase) in HFD models, the meta-analysis showed that excessive consumption of a maternal HFD influences the development of visceral white adipose tissue in offspring, related to adipocyte hypertrophy, regardless of their HFD or control diet consumption. Upon following a long-term HFD, hyperplasia was confirmed in the offspring. When analyzing the secondary outcome in terms of the amount of food and energy consumed, there was an increase of caloric intake in the offspring fed with HFD whose mothers consumed HFD. Furthermore, the adipocyte hypertrophy in different regions of the adipose tissue is related to the sex of the pups. Thus, the adipose tissue obesity phenotypes in offspring are programmed by maternal consumption of a high-fat diet, independent of postnatal diet.
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Affiliation(s)
- Carolina Saullo
- Laboratory of Experimental Research on Gynecology and Obstetrics, Postgraduate Course on Tocogynecology, Botucatu Medical School, Sao Paulo State University (UNESP), Botucatu, São Paulo State, Brazil
| | - Larissa Lopes da Cruz
- Laboratory of Experimental Research on Gynecology and Obstetrics, Postgraduate Course on Tocogynecology, Botucatu Medical School, Sao Paulo State University (UNESP), Botucatu, São Paulo State, Brazil; Laboratory of System Physiology and Reproductive Toxicology, Institute of Biological and Health Sciences, Federal University of Mato Grosso (UFMT), Barra do Garças, Mato Grosso State, Brazil
| | - Débora Cristina Damasceno
- Laboratory of Experimental Research on Gynecology and Obstetrics, Postgraduate Course on Tocogynecology, Botucatu Medical School, Sao Paulo State University (UNESP), Botucatu, São Paulo State, Brazil
| | - Gustavo Tadeu Volpato
- Laboratory of System Physiology and Reproductive Toxicology, Institute of Biological and Health Sciences, Federal University of Mato Grosso (UFMT), Barra do Garças, Mato Grosso State, Brazil
| | - Yuri Karen Sinzato
- Laboratory of Experimental Research on Gynecology and Obstetrics, Postgraduate Course on Tocogynecology, Botucatu Medical School, Sao Paulo State University (UNESP), Botucatu, São Paulo State, Brazil
| | - Barshana Karki
- Laboratory of Experimental Research on Gynecology and Obstetrics, Postgraduate Course on Tocogynecology, Botucatu Medical School, Sao Paulo State University (UNESP), Botucatu, São Paulo State, Brazil
| | - Franciane Quintanilha Gallego
- Laboratory of Experimental Research on Gynecology and Obstetrics, Postgraduate Course on Tocogynecology, Botucatu Medical School, Sao Paulo State University (UNESP), Botucatu, São Paulo State, Brazil
| | - Giovana Vesentini
- Laboratory of Experimental Research on Gynecology and Obstetrics, Postgraduate Course on Tocogynecology, Botucatu Medical School, Sao Paulo State University (UNESP), Botucatu, São Paulo State, Brazil.
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Association of Physical Fitness, Screen Time, and Sleep Hygiene According to the Waist-to-Height Ratio in Children and Adolescents from the Extreme South of Chile. Healthcare (Basel) 2022; 10:healthcare10040627. [PMID: 35455805 PMCID: PMC9026329 DOI: 10.3390/healthcare10040627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/23/2022] [Accepted: 03/23/2022] [Indexed: 02/05/2023] Open
Abstract
Objective: To analyze the perception of physical fitness, screen time, and self-reported sleep hygiene in children and adolescents (CA) from the extreme south of Chile and its associations with waist-to-height ratio (WtHr). Material and methods: An observational cross-sectional study was conducted in a sample of 594 schoolchildren from 5th to 8th grade of primary education, belonging to municipal educational establishments in the Magallanes region, Chile. Cardiorespiratory fitness was assessed through the 20-m shuttle run test, muscle strength through handgrip and the standing broad jump test, physical fitness perception through the International Fitness Scale, and central obesity through the waist-to-height index. In addition, sleep hygiene and screen time were measured. Results: More than 92% of CA spent more than two hours a day watching or using screens. In addition, CA with excess central adiposity had a lower perception of physical fitness, and lower muscle strength and cardiorespiratory fitness compared to CA with normal values of adiposity. Conclusions: CA of the present study spent a high number of hours watching or using screens and had poor sleep quality. In addition, excessive central adiposity was associated with lower physical fitness.
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Libuy N, Bann D, Fitzsimons E. Inequalities in body mass index, diet and physical activity in the UK: Longitudinal evidence across childhood and adolescence. SSM Popul Health 2021; 16:100978. [PMID: 34950761 PMCID: PMC8671115 DOI: 10.1016/j.ssmph.2021.100978] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 11/05/2021] [Accepted: 11/20/2021] [Indexed: 11/20/2022] Open
Abstract
We use longitudinal data across a key developmental period, spanning much of childhood and adolescence (age 5 to 17, years 2006-2018) from the UK Millennium Cohort Study, a nationally representative study with an initial sample of just over 19,000. We first examine the extent to which inequalities in overweight, obesity, BMI and body fat over this period are consistent with the evolution of inequalities in health behaviours, including exercise and healthy diet markers (i.e., skipping breakfast) (n = 7,220). We next study the links between SES, health behaviours and adiposity (BMI, body fat), using rich models that account for the influence of a range of unobserved factors that are fixed over time. In this way, we improve on existing estimates measuring the relationship between SES and health behaviours on the one hand and adiposity on the other. The advantage of the individual fixed effects models is that they exploit within-individual changes over time to help mitigate biases due to unobserved fixed characteristics (n = 6,883). We observe stark income inequalities in BMI and body fat in childhood (age 5), which have further widened by age 17. Inequalities in obesity, physical activity, and skipping breakfast are observed to widen from age 7 onwards. Ordinary Least Square estimates reveal the previously documented SES gradient in adiposity, which is reduced slightly once health behaviours including breakfast consumption and physical activity are accounted for. The main substantive change in estimates comes from the fixed effects specification. Here we observe mixed findings on the SES associations, with a positive association between income and adiposity and a negative association with wealth. The role of health behaviours is attenuated but they remain important, particularly for body fat.
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Affiliation(s)
- Nicolás Libuy
- Centre for Longitudinal Studies, University College London Institute of Education, London, UK
- Corresponding author.
| | - David Bann
- Centre for Longitudinal Studies, University College London Institute of Education, London, UK
| | - Emla Fitzsimons
- Centre for Longitudinal Studies, University College London Institute of Education, London, UK
- Institute for Fiscal Studies, London, UK
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16
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Ding M, Yi X, Yan P, McDonough DJ, Gao Z, Dong X. Application of an Online Combination Exercise Intervention to Improve Physical and Mental Health in Obese Children: A Single Arm Longitudinal Study. Front Psychol 2021; 12:638618. [PMID: 34594257 PMCID: PMC8478076 DOI: 10.3389/fpsyg.2021.638618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 08/16/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction: Childhood obesity has become a global public health concern in the past decade. The purpose of this study was to explore the effectiveness of an online combination exercise intervention in improving the physical and mental health of obese children. Methods: This study adopted a one-group pre-test and post-test research design. A total of 28 obese children from 6 elementary schools in Heze City, Shandong Province, China, were recruited. All participants received an 8-week online combination exercise intervention and were tested at a three-month follow-up. Participants were tested and surveyed regarding their demographic, feasibility, and obesity indicators using mental health and quality of life questionnaires. The data were statistically analyzed using a one-way analysis of variance with repeated measures. Results: A total of 26 obese children (Meanage = 10.15 years) completed the study. The retention rate was 92.9% for the entire trial (two obese children withdrew due to their inability to exercise) and no adverse events were reported. In addition, the obese children completed 25/32 (78.1%) of the online courses. After 8 weeks of the intervention, the changes in the body fat percentage of the obese children [mean difference (MD) = –3.126, p < 0.001, Cohen’s d = –1.777], thinking dimension score (MD = 1.654, p < 0.001, Cohen’s d = 0.603), total quality of life score (MD = 6.385, p < 0.05, Cohen’s d = 0.610), and work attitude dimension score (MD = 1.346, p < 0.001, Cohen’s d = 0.744) showed significant differences compared to the baseline. However, no significant differences were identified between the post-intervention and three-month follow-up measurements (p > 0.05), and we assumed that the intervention effect was maintained three months after the intervention. Conclusion: An online combination exercise intervention is a safe and feasible option to improve the mental health and quality of life of obese children and may have long-term health benefits.
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Affiliation(s)
- Meng Ding
- College of Physical Education, Shandong Normal University, Jinan, China
| | - Xiangren Yi
- Department of Sport and Health, School of Physical Education, Shandong University, Jinan, China
| | - Peisai Yan
- College of Physical Education, Shandong Normal University, Jinan, China
| | - Daniel J McDonough
- School of Kinesiology, University of Minnesota, Minneapolis, MN, United States
| | - Zan Gao
- School of Kinesiology, University of Minnesota, Minneapolis, MN, United States
| | - Xiaosheng Dong
- Department of Sport and Health, School of Physical Education, Shandong University, Jinan, China
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High BMI and Low Muscular Fitness Predict Low Motor Competence in School-Aged Children Living in Low-Resourced Areas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157878. [PMID: 34360171 PMCID: PMC8345384 DOI: 10.3390/ijerph18157878] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 01/14/2023]
Abstract
Childhood obesity is a relatively new problem for Sub-Saharan developing countries. Especially in children with a low socioeconomic background, the link between motor competence, muscular fitness, and body mass index (BMI) remains poorly investigated. Due to the interrelatedness of BMI and physical fitness, the aim of this study is to determine the predictive value of these factors in relation to low motor competence in school-aged children living in low-resourced areas. Motor competence and physical fitness were assessed in 1037 school-aged Ghanaian and South African children using the Performance and Fitness test battery (PERF-FIT). “Low motor competence” was predicted using odds ratios calculated from backward logistic regression analyses. Low motor competence was less prevalent in Ghanaian children (3.7–11.1%) compared to the South African children (21.9–24.2%). Increased BMI and decreased muscular fitness predicted low motor competence in both Ghanaian and South African children. For example, the chance for a Ghanaian child to have low static balance increased by 22.8% (OR = 1.228, p < 0.001) with a 1-point increase in BMI, whereas this decreased by 30.0% (OR = 0.970, p < 0.001) with a 10-cm increase on the standing long jump. In the case of the South African children, if their BMI increased by 1 point, the chance for those children of having low static balance increased by 7.9%, and if their SLJ performance decreased by 10 cm, their chance of low performance increased by 13%. Clearly, motor competence is associated with both BMI and muscular fitness. Policy makers can use this information to counteract the establishment of childhood obesity by promoting weight control through physical activity and stimulating motor competence at school.
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Cardiovascular Effects of Aerobic Exercise With Self-Selected or Predetermined Intensity in Adolescents With Obesity. Pediatr Exerc Sci 2021; 33:125-131. [PMID: 34010805 DOI: 10.1123/pes.2020-0104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 02/05/2021] [Accepted: 02/10/2021] [Indexed: 11/18/2022]
Abstract
This study compared the effects of self-selected exercise intensity (SEI) versus predetermined exercise intensity (PEI) on blood pressure (BP) and arterial stiffness in adolescents with obesity. A total of 37 adolescents, 14.7 (1.6) years old, body mass index ≥95th percentile were randomly allocated into SEI (n = 18; 12 boys) or PEI (n = 19; 13 boys). Both groups exercised for 35 minutes on a treadmill, 3 times per week, for 12 weeks. The SEI could set the speed at the beginning of the sessions and make changes every 5 minutes. The PEI adolescents were trained at an intensity set at 60% to 70% of heart rate reserve. Brachial and central BP, pulse pressure, augmentation index, and carotid-femoral pulse wave were determined at baseline and after 12 weeks. Both groups reduced brachial systolic BP (SEI, Δ = -9 mm Hg; PEI, Δ = -4 mm Hg; P < .01), central systolic BP (SEI, Δ = -4 mm Hg; PEI, Δ = -4 mm Hg; P = .01), and central pulse pressure (SEI, Δ = -4 mm Hg; PEI, Δ = -3 mm Hg; P = .02) without differences between groups. No changes in the augmentation index and carotid-femoral pulse wave were observed in either group. The SEI induced similar changes in various cardiovascular outcomes compared with PEI in adolescents with obesity.
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Hargreaves N, Forneris T, Sabiston C, Berg S, Kowalski K, Ferguson L, Caperchione C. "More than just another physical activity program": exploring the GUM program for at-risk adolescent girls. Health Promot Int 2021; 37:6179650. [PMID: 33749728 DOI: 10.1093/heapro/daab035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Physical activity (PA) levels among adolescent girls continue to steadily decline, especially for those classified as 'at-risk'. To mitigate these trends, Girls United and on the Move (GUM) was created as a dual-component PA and psychosocial program. The primary purpose of this study was to explore participant experiences within GUM, with a secondary purpose of qualitatively informing future PA programs for 'at-risk' adolescent girls. Semi-structured interviews (N = 30) were conducted with a purposeful sample of girls from the GUM program. An inductive thematic analysis was utilized to analyze verbatim transcripts. Two themes were generated from the data: 1) Girls uplifting girls, outlining the importance of a girls-only environment and introducing opportunities for alternative PAs, and 2) finding balance between the physical and psychological, detailing the importance of the dual-component program. These findings provide support for the acceptability of an integrated psychosocial and PA program for at-risk adolescent girls.
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Affiliation(s)
- Nicole Hargreaves
- School of Health and Exercise Sciences, The University of British Columbia Okanagan, 3333 University Way, Kelowna, BC V1V 1V7, Canada
| | - Tanya Forneris
- School of Health and Exercise Sciences, The University of British Columbia Okanagan, 3333 University Way, Kelowna, BC V1V 1V7, Canada
| | - Catherine Sabiston
- School of Health and Exercise Sciences, The University of British Columbia Okanagan, 3333 University Way, Kelowna, BC V1V 1V7, Canada
| | - Stephen Berg
- School of Health and Exercise Sciences, The University of British Columbia Okanagan, 3333 University Way, Kelowna, BC V1V 1V7, Canada
| | - Kent Kowalski
- School of Health and Exercise Sciences, The University of British Columbia Okanagan, 3333 University Way, Kelowna, BC V1V 1V7, Canada
| | - Leah Ferguson
- School of Health and Exercise Sciences, The University of British Columbia Okanagan, 3333 University Way, Kelowna, BC V1V 1V7, Canada
| | - Cristina Caperchione
- School of Health and Exercise Sciences, The University of British Columbia Okanagan, 3333 University Way, Kelowna, BC V1V 1V7, Canada
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Kelley GA, Kelley KS, Pate RR. How Many US Children and Adolescents with Overweight and Obesity Could Improve Their Percent Body Fat by Exercising?: Meta-Analytic Based Estimates. Child Obes 2021; 17:144-150. [PMID: 33544030 DOI: 10.1089/chi.2020.0245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Background: Provide national estimates of the number of US children and adolescents with overweight and obesity who could improve their percent body fat by exercising. Methods: Data were derived from (1) a previous meta-analysis, (2) 2015-2016 prevalence data from the National Health and Nutrition Examination Survey (NHANES), and (3) 2017 US Census population data. Multiplicative calculations were based on (1) number-needed-to treat data from a previous meta-analysis of the number of children with overweight and obesity who could reduce their percent body fat by participating in either aerobic, strength, or combined aerobic and strength training, (2) 2015-2016 NHANES data on the prevalence of children and adolescents with overweight or obesity, and (3) 2017 US Census population data on children and adolescents 2-19 years of age. Results: For both children and adolescents with overweight or obesity, the number who could improve their percent body fat was estimated at 4,388,273 [95% confidence interval (CI) 3,831,523-4,845,023] for either aerobic or strength exercise and 6,507,410 (95% CI 5,744,285-7,267,534) for combined aerobic and strength exercise. Conclusions: A large number of US children and adolescents with overweight and obesity could improve their percent body fat by exercising.
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Affiliation(s)
- George A Kelley
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Kristi S Kelley
- Department of Biostatistics, School of Public Health, West Virginia University, Morgantown, WV, USA
| | - Russell R Pate
- Children's Physical Activity Research Group, Department of Exercise Science, University of South Carolina, Columbia, SC, USA
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21
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Charnaya O, Seifert M. Promoting cardiovascular health post-transplant through early diagnosis and adequate management of hypertension and dyslipidemia. Pediatr Transplant 2021; 25:e13811. [PMID: 32871051 DOI: 10.1111/petr.13811] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/18/2020] [Accepted: 07/13/2020] [Indexed: 12/17/2022]
Abstract
Despite correction of underlying solid organ failure by transplantation, pediatric transplant recipients still have increased mortality rates compared to the general pediatric population, in part due to increased cardiovascular risk. In particular, pediatric kidney and non-kidney transplant recipients with chronic kidney disease have significant cardiovascular risk that worsens with declining kidney function. Biomarkers associated with future cardiovascular risk such as casual and ambulatory hypertension, dyslipidemia, vascular stiffness and calcification, and left ventricular hypertrophy can be detected throughout the post-transplant period and in patients with stable kidney function. Among these, hypertension and dyslipidemia are two potentially modifiable cardiovascular risk factors that are highly prevalent in kidney and non-kidney pediatric transplant recipients. Standardized approaches to appropriate BP measurement and lipid monitoring are needed to detect and address these risk factors in a timely fashion. To achieve sustained improvement in cardiovascular health, clinicians should partner with patients and their caregivers to address these and other risk factors with a combined approach that integrates pharmacologic with non-pharmacologic approaches. This review outlines the scope and impact of hypertension and dyslipidemia in pediatric transplant recipients, with a particular focus on pediatric kidney transplantation given the high burden of chronic kidney disease-associated cardiovascular risk. We also review the current published guidelines for monitoring and managing abnormalities in blood pressure and lipids, highlighting the important role of therapeutic lifestyle changes in concert with antihypertensive and lipid-lowering medications.
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Affiliation(s)
- Olga Charnaya
- Department of Pediatrics, Johns Hopkins University, Baltimore, MD, USA
| | - Michael Seifert
- Department of Pediatrics, University of Alabama School of Medicine, Birmingham, AL, USA
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22
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Kininmonth AR, Smith AD, Llewellyn CH, Dye L, Lawton CL, Fildes A. The relationship between the home environment and child adiposity: a systematic review. Int J Behav Nutr Phys Act 2021; 18:4. [PMID: 33407598 PMCID: PMC7788808 DOI: 10.1186/s12966-020-01073-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 12/14/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Extensive research has demonstrated the role of the Home Environment (HE) in shaping children's energy balance behaviours. Less is known about direct relationships with bodyweight. This review examines associations between the social and physical aspects of three pre-defined Home Environment domains (food, physical activity and media) and adiposity measures in children ≤12 years. METHODS Six electronic databases (PubMed, Medline, EBSCO CINAHL, EMBASE, Web of Science, PsycInfo) were systematically searched up to October 2020. Studies reporting at least one physical and/or social aspect of the food, physical activity and/or media domains of the Home Environment in relation to child adiposity outcomes were included (n = 62). RESULTS Most studies examined one (n = 41) or two domains (n = 16). Only five studies assessed all three domains of the Home Environment. Most consistent relationships were observed for physical aspects of the home media environment; with greater availability of electronic devices associated with higher child adiposity (21/29 studies). Findings were less consistent for the smaller number of studies examining physical aspects of the home food or physical activity environments. 8/15 studies examining physical food environments reported null associations with adiposity. Findings were similarly mixed for physical activity environments; with 4/7 reporting null associations, 2/7 reporting negative associations and 1/7 reporting positive associations between access to physical activity equipment/garden space and adiposity. Fewer studies assessed social aspects (e.g. caregiver modelling or limit setting) of the Home Environment in relation to child adiposity and findings were again mixed; 9/16 media environment, 7/11 food environment and 9/13 physical activity environment studies reported null associations with child adiposity outcomes. CONCLUSIONS The home media environment was most consistently associated with adiposity in childhood. Findings were less consistent for the home food and physical activity environments. Greater agreement on definitions and the measurement of the obesogenic home environment is required in order to clarify the strength and direction of relationships with child adiposity. Robust longitudinal research using comprehensive measures of the holistic home environment is needed to better identify which aspects contribute to excess weight gain in childhood. TRIAL REGISTRATION PROSPERO Systematic review registration number: CRD42018115139 .
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Affiliation(s)
| | - Andrea D Smith
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Clare H Llewellyn
- Research Department of Behavioural Science and Health, University College London, London, UK
| | - Louise Dye
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Clare L Lawton
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
| | - Alison Fildes
- School of Psychology, University of Leeds, Leeds, LS2 9JT, UK
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23
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Kelley GA, Kelley KS, Pate RR. Inter-individual differences in body mass index were not observed as a result of aerobic exercise in children and adolescents with overweight and obesity. Pediatr Obes 2021; 16:e12692. [PMID: 32657544 DOI: 10.1111/ijpo.12692] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 04/09/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Exercise has been recommended as an important intervention for reducing adiposity in children and adolescents with overweight and obesity. OBJECTIVE Determine whether inter-individual differences exist in relation to exercise-induced changes in adiposity among children and adolescents with overweight and obesity. METHODS Meta-analysis of randomized controlled aerobic exercise trials and body mass index (BMI) in kg · m-2 . Change outcome standard deviations were pooled using the inverse-variance heterogeneity model. RESULTS Twenty-eight studies (1185 participants) were included. Inter-individual differences in BMI were -0.1 (95% compatibility interval, -0.7 to 0.7). The 95% prediction interval for inter-individual responses in a future study was -2.9 to 2.9. The probability of a clinically meaningful difference in variability was 29% (possibly clinically important) in favour of controls vs exercisers. CONCLUSIONS Inter-individual differences for BMI in kg · m-2 were not observed as a result of aerobic exercise in children and adolescents with overweight and obesity.
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Affiliation(s)
- George A Kelley
- School of Public Health, Department of Biostatistics, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, West Virginia, USA
| | - Kristi S Kelley
- School of Public Health, Department of Biostatistics, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, West Virginia, USA
| | - Russell R Pate
- Children's Physical Activity Research Group, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
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24
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García-Hermoso A, Izquierdo M, Alonso-Martínez AM, Faigenbaum A, Olloquequi J, Ramírez-Vélez R. Association between Exercise-Induced Changes in Cardiorespiratory Fitness and Adiposity among Overweight and Obese Youth: A Meta-Analysis and Meta-Regression Analysis. CHILDREN-BASEL 2020; 7:children7090147. [PMID: 32967205 PMCID: PMC7552631 DOI: 10.3390/children7090147] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/14/2020] [Accepted: 09/18/2020] [Indexed: 11/16/2022]
Abstract
The aim of this study was to determine the minimum change in cardiorespiratory fitness (CRF) required to reduce adiposity (percent body fat) in exercise programs for overweight and obese youth. Studies were identified through a systematic search of five databases. Studies were limited to randomized controlled trials (RCTs) of exercise training (e.g., aerobic, strength, concurrent) that assessed percent body fat and CRF for both exercise and control groups in overweight and obese children and adolescents. A series of meta-regressions were conducted to explore links between change in CRF (maximum oxygen consumption, ml/kg/min) and change in percent body fat. Twenty-three RCTs were included (n = 1790, 59% females). Meta-regression analysis suggested that increases of at least 0.38 mL/kg/min in CRF (p < 0.001) were considered to be a clinically important reduction of percent body fat (−2.30%, 95% confidence interval −3.02 to −1.58; p < 0.001; I2 = 92.2%). Subgroup analysis showed that increases of at least 0.17 mL/kg/min in CRF favored a reduction of percent body fat of −1.62% (95% confidence interval −2.04 to −1.20; p < 0.001; I2 = 69.9%). In conclusion, this change in CRF could be considered by pediatric researchers, youth fitness specialists, and health care providers to determine the effectiveness in body fat reductions through exercise.
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Affiliation(s)
- Antonio García-Hermoso
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, 31008 Pamplona, Navarra, Spain; (M.I.); (R.R.-V.)
- Facultad de Ciencias Médicas, Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, USACH, Santiago 71783-5, Chile
- Correspondence:
| | - Mikel Izquierdo
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, 31008 Pamplona, Navarra, Spain; (M.I.); (R.R.-V.)
- Department of Health Sciences, Public University of Navarra, 31006 Pamplona, Navarra, Spain;
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 28001 Madrid, Spain
| | | | - Avery Faigenbaum
- Department of Health and Exercise Science, The College of New Jersey, Ewing, NJ 08628, USA;
| | - Jordi Olloquequi
- Instituto de Ciencias Biomédicas, Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca 3460000, Chile;
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), Universidad Pública de Navarra (UPNA), IdiSNA, 31008 Pamplona, Navarra, Spain; (M.I.); (R.R.-V.)
- Department of Health Sciences, Public University of Navarra, 31006 Pamplona, Navarra, Spain;
- CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, 28001 Madrid, Spain
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25
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Orsso CE, Colin-Ramirez E, Field CJ, Madsen KL, Prado CM, Haqq AM. Adipose Tissue Development and Expansion from the Womb to Adolescence: An Overview. Nutrients 2020; 12:E2735. [PMID: 32911676 PMCID: PMC7551046 DOI: 10.3390/nu12092735] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 08/29/2020] [Accepted: 09/02/2020] [Indexed: 02/07/2023] Open
Abstract
Prevalence rates of pediatric obesity continue to rise worldwide. Adipose tissue (AT) development and expansion initiate in the fetus and extend throughout the lifespan. This paper presents an overview of the AT developmental trajectories from the intrauterine period to adolescence; factors determining adiposity expansion are also discussed. The greatest fetal increases in AT were observed in the third pregnancy trimester, with growing evidence suggesting that maternal health and nutrition, toxin exposure, and genetic defects impact AT development. From birth up to six months, healthy term newborns experience steep increases in AT; but a subsequent reduction in AT is observed during infancy. Important determinants of AT in infancy identified in this review included feeding practices and factors shaping the gut microbiome. Low AT accrual rates are maintained up to puberty onset, at which time, the pattern of adiposity expansion becomes sex dependent. As girls experience rapid increases and boys experience decreases in AT, sexual dimorphism in hormone secretion can be considered the main contributor for changes. Eating patterns/behaviors and interactions between dietary components, gut microbiome, and immune cells also influence AT expansion. Despite the plasticity of this tissue, substantial evidence supports that adiposity at birth and infancy highly influences its levels across subsequent life stages. Thus, a unique window of opportunity for the prevention and/or slowing down of the predisposition toward obesity, exists from pregnancy through childhood.
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Affiliation(s)
- Camila E. Orsso
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2E1, Canada; (C.E.O.); (C.J.F.); (C.M.P.)
| | | | - Catherine J. Field
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2E1, Canada; (C.E.O.); (C.J.F.); (C.M.P.)
| | - Karen L. Madsen
- Department of Medicine, University of Alberta, Edmonton, AB T6G 2C2, Canada;
| | - Carla M. Prado
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2E1, Canada; (C.E.O.); (C.J.F.); (C.M.P.)
| | - Andrea M. Haqq
- Department of Pediatrics and Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB T6G 2R7, Canada
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Multicomponent Exercise Training Combined with Nutritional Counselling Improves Physical Function, Biochemical and Anthropometric Profiles in Obese Children: A Pilot Study. Nutrients 2020; 12:nu12092723. [PMID: 32899955 PMCID: PMC7551745 DOI: 10.3390/nu12092723] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 08/24/2020] [Accepted: 09/02/2020] [Indexed: 01/15/2023] Open
Abstract
Aerobics or strength exercise plus diet interventions have been shown to counteract childhood obesity. However, little is known with regard to periodized multicomponent exercise interventions combined with nutritional counselling, which might be less demanding but more enjoyable and respectful of children and adolescents’ nature. In order to analyze the impact of such a multimodal approach, 18 obese children (10.8 ± 1.6 years; 63% females; z Body Mass Index 3 ± 0.4) trained for 60 min, twice weekly and were measured for body composition, biochemical parameters and physical function. We found that 16 weeks of multimodal intervention (14 of training), based on fun-type skill-learning physical activities and physical conditioning with challenging circuits and games, together with nutritional counselling, led to an attendance > 80%, with significant overall health improvement. Body composition was enhanced (p < 0.01 for z BMI, mid-upper-arm-circumference, waist-to-height ratio, tricipital and subscapular skinfolds, body-fat % by Slaughter equation and Dual energy X-ray absorptiometry body fat% and trunk fat%), as well as metabolic profile (LDL cholesterol, gamma-glutamyl transferase , alanine aminotransferase ; p < 0.05), homeostatic model assessment of insulin resistance (HOMA-IR; p < 0.05) and inflammatory response (C-Reactive Protein; p < 0.05). Physical fitness was also improved (p < 0.01) through better cardiovascular test scores and fundamental movement patterns (Functional Movement Screen-7, FMS-4). Tailoring multimodal supervised strategies ensured attendance, active participation and enjoyment, compensating for the lack of strict caloric restrictions and the low volume and training frequency compared to the exercise prescription guidelines for obesity. Nutritional counselling reinforced exercise benefits and turned the intervention into a powerful educational strategy. Teamwork and professionals’ specificity may also be key factors.
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27
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Kelley GA, Kelley KS, Pate RR. Are There Inter-Individual Differences in Fat Mass and Percent Body Fat as a Result of Aerobic Exercise Training in Overweight and Obese Children and Adolescents? A Meta-Analytic Perspective. Child Obes 2020; 16:301-306. [PMID: 32486838 DOI: 10.1089/chi.2020.0056] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Determine whether inter-individual response differences exist with respect to changes in fat mass and percent body fat as a result of aerobic exercise training in overweight and obese children and adolescents. Methods: Using the meta-analytic approach, randomized controlled trials that examined the effects of aerobic exercise training on fat mass and percent body fat in overweight and obese children and adolescents were included. Change outcome standard deviations for fat mass and percent body fat were used to calculate true inter-individual differences from each study. The inverse variance heterogeneity model was used to pool results. Results: Pooled changes for inter-individual response differences in fat mass (16 studies, 575 participants) were 0.9 kg (95% confidence interval [CI], -1.4 to 1.8 kg) while tau ([Formula: see text]) was 2.9. For percent body fat, inter-individual differences (27 studies, 1035 participants) were 0.6% (95% CI, -0.6% to 1.0%, [Formula: see text] = 0.7). The 95% prediction interval for true inter-individual responses in a future study was -4.9 to 5.5 kg for fat mass and -0.7% to 1.7% for percent body fat. The percent chance, that is, probability, of a clinically meaningful difference in variability was 47% for fat mass and 26% for percent body fat, both of which were considered as only possibly clinically important. Conclusions: There is a lack of convincing evidence to suggest that true inter-individual response differences exist with respect to aerobic exercise training and changes in fat mass and percent body fat in overweight and obese children and adolescents.
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Affiliation(s)
- George A Kelley
- Department of Biostatistics, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, USA
| | - Kristi S Kelley
- Department of Biostatistics, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, WV, USA
| | - Russell R Pate
- Department of Exercise Science, Children's Physical Activity Research Group, University of South Carolina, Columbia, SC, USA
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28
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Caperchione CM, Hargreaves N, Sabiston CM, Berg S, Kowalski KC, Ferguson LJ. Exploring the Effectiveness of an Integrated Physical Activity and Psychosocial Program Targeting At-Risk Adolescent Girls: Protocol for the Girls United and on the Move (GUM) Intervention Study. JMIR Res Protoc 2020; 9:e15302. [PMID: 32515748 PMCID: PMC7312238 DOI: 10.2196/15302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 02/18/2020] [Accepted: 04/10/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Adolescents are highly susceptible to negative self-perceptions, likely due to their social cues and environment. The presence of these negative self-perceptions has been shown to adversely impact levels of physical activity (PA). Although PA has the ability to foster improved self-perceptions, the rates of PA among adolescents continue to descend, with girls appearing to be most susceptible to these declines. At-risk adolescent girls, who may experience a number of negative preceding lifestyle conditions, may be exceptionally vulnerable to declines in PA. There are a high number of adolescent girls from low-income and abusive households in British Columbia, Canada, thus indicating a need for a program to relay the importance of PA and healthy lifestyle behaviors. OBJECTIVE This paper aims to describe the protocol of the Girls United and on the Move (GUM) pragmatic intervention, an integrated PA and psychosocial program aimed at improving self-compassion, social connectedness, and overall self-perceptions among at-risk adolescent girls. METHODS Using a quasi-experimental mixed methods approach, the GUM intervention was conducted in 5 schools in British Columbia, Canada. Adolescent girls aged 11 to 15 years who were identified as at risk were included in the study. The 9-week intervention, co-delivered by a PA/health promotion-trained researcher and a registered social worker, involved a PA component and a psychosocial component with evidence-based topics addressing the concerns of the adolescent girls. The following outcomes were evaluated: PA, self-compassion, social support, leader supportiveness, and sport enjoyment and commitment. Program acceptability and satisfaction was also examined. Outcome measures were assessed at baseline (week 1), week 6, and postintervention (week 9), and interview data concerning program acceptability and satisfaction were collected at postintervention from a subsample of participants. RESULTS A total of 101 participants were invited to participate in the GUM intervention. Reporting of the results is projected for the fall of 2020. CONCLUSIONS It is anticipated that the GUM intervention will enhance PA while also improving self-compassion, social connectedness, and overall self-perceptions among at-risk adolescent girls. The findings of this research will contribute to the literature concerning PA and various psychosocial factors that impact the physical and mental health of at-risk adolescent girls. TRIAL REGISTRATION Clinicaltrials.gov NCT03567200; https://clinicaltrials.gov/ct2/show/NCT03567200. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/15302.
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Affiliation(s)
- Cristina M Caperchione
- School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, Australia
| | - Nicole Hargreaves
- School of Health and Exercise Science, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Catherine M Sabiston
- Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, ON, Canada
| | - Stephen Berg
- Okanagan School of Education, University of British Columbia Okanagan, Kelowna, BC, Canada
| | - Kent C Kowalski
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
| | - Leah J Ferguson
- College of Kinesiology, University of Saskatchewan, Saskatoon, SK, Canada
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